非奈利酮聯(lián)合標準方案治療射血分數(shù)輕度降低型或保留型心力衰竭的藥物經(jīng)濟學評價

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中圖分類號R956 文獻標志碼A 文章編號 1001-0408（2025）14-1770-05

DOI 10.6039/j.issn.1001-0408.2025.14.14

ABSTRACTOBJECTIVEToevaluate thecost-efectivenessof finerenonecombinedwith standardofcare（SoC）inthe treatmentofheartfailurewithmildlyreducedejectionfraction（HFmrEF）orpreservedejectionfraction（HFpEF）.METHODS BasedonaphaseIIclinical tial，a MarkovmodelwasconstructedfromtheperspectiveofChina’shealthcaresystemtocompare thetreatmentoutcomesoffinerenonecombinedwithSoCregimenversusSoCregimenaloneinthetreatmentofdiferentcardiac functionalstatusesofHFmrEF/HFpEF.Usingquality-adjustedlifeyear（QALY）asthehealthoutputindex，3times China’sper capita GDPin2023asthewilingnes-to-pay（WTP）threshold，asimulationwasconducted witha3-monthcyclelengthanda10- year time horizon，incorporating an annual discount rate of 5% .The dynamic changes across various stages of HFmrEF/HFpEF treatedwith finerenonecombinedwithSoCversusSoCaloneweresimulatedtoevaluatethelong-termefectivenessandcostsof the twotreatmentstrategies.Additionally，oe-waysensitivityanalysisndprobabilisticsnsitivityanalysswereperformed，totesthe robustnessof theresults.RESULTSTheicrementalcost-efectivenessratio（ICER）ofthefinerenonecombinedwith SoCregimen versusSoCregimenalonewas179504.75yuan/QALY，whichwas belowtheWTPthresholdset inthis study，indicating thatthe finerenonecombinedwith SoCregimenposessedcertaineconomicadvantages.Theresultsofone-waysensitivityanalysis showed thattheutiltyvalueofNYHAIstatus，thedrugpriceoffierenone，thediscountrate，andtheprobabilityofhospital tansfefor bothgroups hadagreat influenceonICER，butdidnotafect therobustessofthemodel.Theprobabilisticsensitivityanalysisalso confirmedtherobustnessof the model.CONCLUsIONS Under theWTPthresholdset inthis study，finerenonecombined with SoC is cost-effective in the treatment of HFmrEF/HFpEF，compared with the SoC regimen.

KEYWORDSfinerenone；HFmrEF；HFpEF；Markov model；cost-utility analysis

心力衰竭（heartfailure，HF）是各種心臟疾病的嚴重表現(xiàn)或晚期階段，以呼吸困難、疲乏和液體潴留等為主要臨床表現(xiàn)，具有較高的患病率和死亡率[1-2]。（剩余10070字）